Download - DAV Public School

D.A.V. PUBLIC SCHOOL, KALINGA NAGAR, BHUBANESWAR-03.
IMPORTANT INFORMATION SHEET FOR LKG ADMISSION
1.SCHEDULE:
Issue of Registration Forms
-
Submission of Registration Forms and Verification of documents.
Date of draw of lots (if required)
Display of selected candidates on School Notice Board and Website
Date of Provisional Admission for selected candidates
03/03/2014 to 10/03/2014
Time- 10.30 A.M. to 1.00 P.M.
03/03/2014 to 10/03/2014
Time- 10.30 A.M. to 1.00 P.M.
14/03/2014 between 11.00 A.M.to 2.00 P.M.
15/03/2014 at 5.00 P.M.
_20 /03/2014
( The exact time will be
mentioned in the Provisional Selection list)
2. Please submit the Registration form as per the date and time mentioned above and take the index card
after being registered and signed by the receiving officer.
3. Under no circumstances the date and time for submission of forms can be extended.
4. For the entry class i.e. L.K.G., children whose date of birth falls between 1st October 2009
and 30thSeptember 2010 only are eligible for registration for the academic session 2014-15.
5.For Special Category Candidates documents required to issue the Registration Form free of cost.
A) For Disadvantaged Group (SC/ ST / SEBC)
(i) In case of SC/ST candidates, Original & attested Photocopy of Caste Certificate in the name of the
child seeking for admission.
(ii) In case of SEBC candidates, recent Original & attested photocopy of SEBC Certificate issued
by the Tahasildar, Bhubaneswar.
(iii) Original and attested photocopy of document like electricity bill/water bill/telephone bill/ Ration
Card / Passport to be produced in support of proof of residence (within 1 k.m. of the school).
The said documents must be in the name of parents of the ward seeking for admission.
B). For Weaker Section ( BPL Card Holder)
(i) Recent Original & attested photocopy of BPL Card in the name of Parents.
(ii) Original and attested photocopy of document like electricity bill/water bill/telephone bill/ Ration
Card/ Passport to be produced in support of proof of residence(within 1 k.m. of the School).
The said documents must be in the name of the parents of the ward seeking for admission.
C) In case of above two categories the place of residence may be verified by the school authority before
issuing the Registration forms.
6. The name of the Alumnus/Alumna who is desirous to apply for registration of his/her child should
mention his/her name in column-14.(ii). Enclose attested photocopy of AISSE/AISSCE certificate(s) as
the supporting document.
7. If the applicants exceed the number of seats available in any of the categories, random selection
method will be adopted and the list of selected candidates will be finalized on 14/03/2014 between
11.00 A.M. to 2.00 P.M.
8. The Fee matter for the session 2014-15 is sub - judice before the Hon’ble Supreme Court. So a
consolidated amount of 30000/- towards admission and
5000/- towards books, School bag,
identity card, activity and smart class will be collected at the time of provisional admission. The
differential fee if any will be collected or adjusted after final decision of the Hon’ble Supreme Court.
Sd/
PRINCIPAL
D.A.V PUBLIC SCHOOL
Kalinga Nagar, Post - Ghatikia, Bhubaneswar-751003.
REGISTRATION FORM FOR PROVISIONAL ADMISSION INTO
LKG FOR THE SESSION-2014-15
FOR OFFICE USE ONLY
Money Receipt No_______________ Date ______________
Form No
School No /
Index No
Admn. No
Date
(All information should be filled up in block letters)
1.
Name of the student :__________________________________________________________
(In Block letters)
2. Gender: _______________ 3. Nationality_____________________
Paste recent B2 size
4. Date of Birth :
(a) (i) In Figures
(ii) In words
DD
MM
YY
(7cm X5cm) photograph of
the child along with the
parents
________________________________________________________________
(b) Age as on 01 .04. 2014 :
Years_______________ Months _____________________ Days ________________________
5. Blood Group : _____________________
6. Mother Tongue____________________________
7. Caste: ____________________________ 8. Minority Community (If applicable)_____________
9. Chronic/serious illness, if any : ____________________________________________________
10. Mode of transport for attending School: Own Arrangement/School bus___________________
11. PARENT INFORMATION
Father’s Name:___________________________
Academic Qualification:____________________
Occupation: ______________________________
Designation: _____________________________
Organisation:_____________________________
Office Address: ___________________________
_________________________________________
Annual income: ___________________________
PhPhone#(O):
Phone#(M)
E-mail id : ______________________________
Mother’s Name:___________________________
Academic Qualification:____________________
Occupation: ______________________________
Designation: ______________________________
Organisation:_____________________________
Office Address: ___________________________
________________________________________
Annual income __________________________
PhPhone#(O):
Phone#(M)
E-mail id: _____________________________
12. Residential Address:
(a) Plot/House No _____________ (b) Locality_________________________________________,
(c)Post Office _________________________________________
(d) Pin_________________
(e) Distance from DAV Public School, Kalinga Nagar : ____________________________K.Ms
13. Permanent Address:
(a) Plot/House No./Village___________________________(b) Post_________________________
(c) Dist _________________________________________ (d) State_________________________
(e) PIN________________________________
14. Tick the appropriate box in case you belong to any of the following categories.
(i)
Special Category
___________________________________________
(Mention Disadvantaged Group or Weaker Section)
(ii)
Alumnus/ Alumna
Name : _____________________________________
Year of passing AISSE/AISSCE: _______________
(iii)
Staff
Name : _____________________________________
DECLARATION
 I/We, hereby certify that the above information is correct to the best of my/our knowledge and
belief. If any information is found to be contrary to the facts, the admission of my/our ward may be
cancelled at any stage.
 Further, I/we fully understand that filling up of this Registration Form does not confirm the
admission of the child.
 I/We declare that I/we am/are in a position to pay the prescribed fees as finalized by the school.
 The name & date of birth of my/our ward as spelt out is correct and I/we shall not request for its
change at a later stage.
 I/ We hereby certify that my/our ward and myself/ourselves shall follow all the rules, regulations
and procedures as laid down by the School from time to time.
 I/We understand that the decision of the Management of the school shall be final & binding on
me/us.
 I/We certify that I/we am/are the bonafide guardian/guardian(s) of the child.
Signature of the Mother
Signature of the Father
Date :_______________
Date: ______________
Signature of Legal Guardian(Incase parents aren’t alive)
Name of Legal Guardian__________________________________ Date : _______________
ENCLOSURES
Please put a ()mark on the appropriate box
1. 1. Attested Photo copy of Birth Certificate.4. 4. Attested photocopy of BPL Card
2.
(For all categories)
( In case of Weaker Section category)
3. Yes
No
Yes
No
4.
2. Money receipt of the Prospectus
6. 5. Attested photocopy of Caste Certificate
(In case of General category)
7. (In case of Disadvantage Group & Weaker Section)
5.
Yes
No
Yes
No.
6. Residence proof documents:
3. Attested photocopy of AISSE/AISSCE
certificate (In case of Alumni candidate)
Yes
No
(In case of Disadvantage group &Weaker section)
a)Electricity bill
b)Water bill
( c) Telephone bill
(e) Passport
d) Ration card
DAV PUBLIC SCHOOL
Kalinga Nagar, Bhubaneswar-751003
INDEX CARD FOR L.K.G.- 2014-15
(TO BE FILLED BY THE PARENTS)
Registration Form No…………………………………………………………………..
Name of the Child………………………………………………………………………
(In Capital Letters)
Mother’s Name………………………………………………………………………….
(In Capital Letters)
Father’s Name…………………………………………………………………………..
(In Capital Letters)
Mention the Category………………………………………………………………….
(FOR OFFICE USE ONLY)
Index No…………………………………………………., Date………………………
Kindly refer the Index No. for all information.
Signature of the
Receiving Officer

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